2010 July - Note 8

Patient in labor — Legal duty of non-gynecologists to assist - R. J. Singh, Advocate, Mumbai High Court

In the case of Dr. Arun Dewangan vs. Madhu (Preti Chandel) & Anr. (page a86/j246) the National Consumer Commission has rightly held that delivery by an ayurvedic doctor is negligence. However, there have been innumerable instances where a woman has delivered her child in a jungle, a moving bus or a train. One important question that arises for consideration is, what must a doctor, who is not a gynecologist or for that matter who could even be an ayurvedic doctor, do, when a patient in labor is simply rushed into his or her consulting room? Should he or she simply refuse to touch the patient as she is admittedly outside his or her area of expertise? Or should the doctor try to do whatever best he or she can do, till the time a qualified gynecologist arrives or the patient is transferred to another appropriate hospital?

The Clinical Establishments (Registration and Regulation) Bill, 2010, which may soon become the law of the land mandates that clinical establishments shall provide ‘such medical examination and treatment as may be required to stabilize the emergency medical condition’. Section 2 (d) (i) of this Bill defines ‘emergency medical treatment’ and categorically includes ‘… with respect to a pregnant woman, the health of the woman or her unborn child, in serious jeopardy.’ So in effect, even an orthopedic hospital will have to accept a woman in labor and provide the appropriate treatment.

The next question that arises is whether individual doctors are also bound to provide care in emergencies? The answer lies in the judgment delivered by the Supreme Court way back in 1986, in the case of Parmanand Katara laying down the law that every doctor is duty bound to render help to an emergency patient. This duty to render assistance is ‘total, absolute, and paramount’.

Therefore, even if the aforementioned Bill does not become law, the duty to accept, treat, and manage emergency patients will remain binding on all doctors and hospitals in India. 

A woman in labor is a medical emergency, and hence, an orthopedic surgeon or a general physician or even an ayurvedic doctor can assist in the delivery. Help and advice from qualified gynecologists must be sought, even if it is on the telephone. Efforts must be made to transfer the patient to an appropriate facility, if possible, and if it does not compromise the safety of the mother and the unborn child.

On general principles of law, it can be safely stated that in an emergency, that is, when a woman is in labor, the rule that delivery patients must be managed only by qualified gynecologists will not be applicable. On the contrary if a doctor fails to respond appropriately in such a situation, it will be illegal.

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